01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-08-29 | 6 | 2024-08-29 | 0 |
| Cycle 2 | 2023-08-31 | 11 | 2023-08-31 | 1 |
| Cycle 3 | 2022-10-14 | 6 | 2022-10-14 | 2 |
CMS CCN 1250132026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Maunalani Nursing And Rehabilitation Center
5113 Maunalani Circle · Honolulu, HI 96816 · Honolulu County
Certified beds100CMS provider file
Recent citation rows26current CMS citation release
Penalty rows2current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
26 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-10 · HEALTHF0585Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Correction field: Deficient, Provider has date of correction · 2026-07-17 · complaint2026-06-10 · HEALTHF0712Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Correction field: Deficient, Provider has date of correction · 2026-07-17 · complaint2025-08-14 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-09-15 · complaint · under IDR/IIDR2024-10-18 · HEALTHF0661Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Correction field: Deficient, Provider has date of correction · 2024-11-09 · complaint2024-10-18 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-11-09 · complaint2024-10-18 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-11-09 · complaint2024-10-18 · HEALTHF0711Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Correction field: Deficient, Provider has date of correction · 2024-11-09 · complaint2024-08-29 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-09-23 · complaint2024-08-29 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2024-09-232024-08-29 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2024-09-232023-08-31 · HEALTHF0578Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Correction field: Deficient, Provider has date of correction · 2023-09-242023-08-31 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2023-09-242023-08-31 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2023-09-242023-08-31 · HEALTHF0806Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Correction field: Deficient, Provider has date of correction · 2023-09-242023-08-31 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2023-09-242023-08-31 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2023-09-242023-08-31 · HEALTHF0921Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2023-09-242023-08-31 · FIREK0914Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2023-09-292022-10-14 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2022-11-172022-10-14 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2022-11-172022-10-14 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2022-11-172022-10-14 · HEALTHF0803Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Correction field: Deficient, Provider has date of correction · 2022-11-172022-10-14 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2022-11-172022-10-14 · HEALTHF0921Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2022-11-1703 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2025-08-14 | Fine | $24,115 | 0 |
| 2024-10-18 | Fine | $8,018 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- THE MAUNALANI FOUNDATIONOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 03/16/1987
- BLANCHETTE, PATRICIAIndividual · CONTRACTED MANAGING EMPLOYEENOT APPLICABLE · since 06/01/2013
- CHANTAVY, SAIIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 12/28/2015
- FLORES, JEROMEIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 07/23/2018
- CHOY, MELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/07/2019
- GOLDCAMP, JOSEPHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/28/2015
- HASEYAMA, KEVINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/23/2022
- HEIRAKUJI, LYNNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/17/2019
- PEROFF, RODERICKIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/28/2015
- SOMBRERO, STEVEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/07/2019
- TODANI, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/28/2015
- WRISTON, ARTHURIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/28/2015
- YASUDA, NEALIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/11/2018
- CHANTAVY, SAIIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/28/2015
- FLORES, JEROMEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/23/2018
- CHANTAVY, SAIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/03/2024
- THE MAUNALANI FOUNDATIONOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/23/2024
- BLANCHETTE, PATRICIAIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/23/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours5.51per resident day
RN hours1.62per resident day
Weekend nurse hours4.86per resident day
Staff turnover97.4%CMS reported field
06 / LOCAL RECORDS
Open the Honolulu ledger →Other published facilities nearby
15 Craigside45 beds · CMS overall 5/55 citation rowsArcadia Retirement Residence91 beds · CMS overall 4/543 citation rowsAvalon Care Center - Honolulu, Llc108 beds · CMS overall 2/561 citation rowsHale Malamalama40 beds · CMS overall 2/552 citation rowsHale Nani Rehabilitation And Nursing Center288 beds · CMS overall —/5107 citation rowsHi'Olani Care Center At Kahala Nui20 beds · CMS overall 5/526 citation rowsIslands Skilled Nursing & Rehabilitation42 beds · CMS overall 1/565 citation rowsKalakaua Gardens49 beds · CMS overall 2/560 citation rows